Legal

Work­mans Com­pen­sa­tion Fraud Policy

Any employee who sus­pects work­ers’ com­pen­sa­tion fraud should notify his or her super­vi­sor imme­di­ately. Super­vi­sors who receive infor­ma­tion about sus­pected work­ers’ com­pen­sa­tion fraud must report that infor­ma­tion to Pinnacle.

Exam­ples of work­ers’ com­pen­sa­tion fraud include, but are not lim­ited to:

• Mak­ing a false or mis­lead­ing state­ment to receive work­ers’ com­pen­sa­tion ben­e­fits (Exam­ple: report­ing an injury that does not exist)
• Mis­rep­re­sent­ing or con­ceal­ing a mate­r­ial fact to receive work­ers’ com­pen­sa­tion ben­e­fits (Exam­ple: report­ing an off-duty injury as a work-related injury)
• Fab­ri­cat­ing, alter­ing, con­ceal­ing or destroy­ing a doc­u­ment to receive work­ers’ com­pen­sa­tion ben­e­fits (Exam­ple: with­hold­ing a doctor’s release to return to work form)
• Con­spir­ing to com­mit an act described above (Exam­ple: help­ing another employee stage or fake a work-related injury)

Pin­na­cle may inves­ti­gate any alle­ga­tions of work­ers’ com­pen­sa­tion fraud. For this pur­pose, Pin­na­cle will have access to all com­pany activ­i­ties, records, prop­erty and per­son­nel required to inves­ti­gate the alleged fraud on a “need to know” basis, as deter­mined by the pres­i­dent, and sub­ject to applic­a­ble law.

Pin­na­cle will coop­er­ate fully with our Insur­ance Car­rier, as well as fed­eral, state and local law offi­cials, to iden­tify and pros­e­cute any employee who com­mits or con­spires to com­mit work­ers’ com­pen­sa­tion fraud.

Pinnacle’s gen­eral coun­sel or legal rep­re­sen­ta­tive will pro­vide legal guid­ance, advice and coun­sel­ing in the use and enforce­ment of this policy.